Integrated Teleconferencing Unit For Home-Based Interactive Exercise For Elders

描述（由申请人提供）：有监督的团体运动已被证明是改善平衡和预防跌倒的有效组成部分，适用于遭受跌倒或因身体虚弱而表现出跌倒恐惧的长者。在第一阶段的SBIR研究中，我们开发了一种模式，通过视频会议为老年人在家中进行小组锻炼项目，称为远程小组锻炼（tele-ex），使用一种改装的、商业的、现成的视频会议设备，连接到老年人的家庭电视上。远程训练允许老年人在家中参加有监督的团体锻炼课程，同时允许实时、双向的指导、参与和锻炼教练的监督，教练可以同时观察所有的参与者。本SBIR第二阶段应用的目标是进一步完善视频会议设备，并进一步评估与传统社区团体锻炼（comm-ex）和家庭个人锻炼（home-ex）计划相比，远程锻炼计划的依从性、有效性、质量和满意度。目标人群是有跌倒风险的社区老年人。第二阶段的具体目标包括：发展一套专为长者家居而设的视像会议装置，以实现视像会议装置的商品化，并提供方便的家居运动计划。2. 评估社区居住、有跌倒风险的老年人对远程锻炼计划的依从性和有效性，与普通锻炼计划和家庭锻炼计划相比较。3. 评估社区居住长者的远程通讯质素及对远程通讯技术的满意程度。我们将进行一项随机对照试验，涉及三组（远程ex组、通信ex组和家庭ex组），每组进行15周的太极锻炼计划，并进行运动前和运动后测试。我们将测试72名受试者，每组24人。我们的假设是：1)与普通和居家服务组相比，远程服务组的老年人有更高的运动坚持率；2)与居家运动组的老年人相比，远程运动组的老年人对摔倒的恐惧会减少，运动后的平衡能力和生活质量会提高。这项研究专门针对美国老年人致残的一个主要原因：意外跌倒。有规律的运动，比如太极拳，已经被证明可以降低跌倒的风险和对跌倒的恐惧。由于大多数老年人缺乏体育锻炼，通过视频会议将互动式和有监督的锻炼计划发送到老年人自己的家中，电视为他们提供了一种有吸引力的方式，使他们参与定期锻炼，从而提高平衡能力，降低跌倒和跌倒受伤的风险，并提高独立性。

DESCRIPTION (provided by applicant): Supervised group exercise has been shown to be an effective component for improving balance and preventing falls among elders who have suffered falls or exhibit a fear of falling due to frailty. In a Phase I SBIR study, we developed a model for conducting group exercise programs for elders in their homes via video- conferencing, called tele-based group exercise (tele-ex), using a modified, commercial, off-the-shelf videoconferencing device attached to an elder's home television. The tele-ex allowed elders to participate in supervised group exercise classes from their homes, while allowing real-time, two-way instruction, participation, and supervision by an exercise instructor who could simultaneously observe all of the participants in the class. The goals of this SBIR Phase II application are to further refine the video-conferencing device, and to further evaluate the adherence, effectiveness, and quality and satisfaction of the tele-ex program as compared to traditional community-based group exercise (comm-ex) and home-based individual exercise (home-ex) programs. The target population is community-dwelling elders who are at risk for falls. Specific aims for Phase II include: 1. Develop a purpose-built videoconferencing unit for use in the elder's home, with the view of commercialization of the videoconferencing unit, and a service for delivering facilitated home-based exercise programs. 2. Evaluate the adherence to and effectiveness of the tele-exercise program among community-dwelling, fall- risk elders, as compared to comm-ex and home-ex programs. 3. Evaluate the quality of tele-communication and the level of satisfaction of tele-ex technology by community- dwelling elders. We will conduct a randomized controlled trial, involving three groups (a tele-ex group, a comm-ex group, and a home-ex group), each with a 15-week Tai Chi exercise program, and pre- and post-exercise tests. We will test a total of 72 subjects, 24 in each group. We hypothesize that 1) compared to elders in both comm-ex and home-ex groups, elders in the tele-ex group will have a higher exercise adherence rate; and 2) compared to elders in the home-ex group, elders in the tele-ex group will have decreased fear of falling, increased balance and quality of life post exercise. The study aims specifically at one major cause of disability in the elderly population in the U.S: unintentional falls. Participation in regular exercises, such as Tai Chi, has been shown to reduce the risk of falls and fear of falling. With a majority of elders being physically inactive, interactive and supervised exercise programs delivered via videoconferencing to elders' own home television present an attractive way to engage them in regular exercises, leading to improved balance, reduced risk of falls and fall injuries, and independence.